how to fix low back pain – Tony Gentilcore

Back tweaks are an inevitability.

They happen to people who lifts weights regularly, and those who just look at weights. They happen when doing something as inane as bending over to tie your shoes, as well as when you’re doing some less inane, like, fighting crime at night.

They happen on a Wednesday.

There’s no way to predict when they’ll happen, they just will. Especially if you’re someone who’s had the unfortunate misfortune of it happening once or twice (or many times) in the past.

What can you do when this happens?

I Jacked My Low Back, Now What(?) Workout

This happened to me several months ago.

The culprit wasn’t anything “cool” like a 1-rep max, or, I don’t know, wrestling a lumberjack.

Nope. Not even close.

This time it came about doing nothing more than bending over to perform my last set of Landmine Rows. As soon as I grabbed the handle I felt that slight zappy “zzzzzzzzzzz” feeling in my lower back and it seized up.

I was hoping to persevere and follow suite with my normal coaching schedule with clients, but it became apparent I was going to be uncomfortable the rest of the day. I went home a little early, stayed horizontal with a heating pad, caught up on all the episodes of Atlanta I hadn’t watched yet (season 3 has been spectacular if you ask me), and woke up the following morning feeling marginally better.

I skipped my scheduled training session that day, but didn’t skip it altogether. Instead I elected to follow my own advice and went into #findyourtrainablemenu mode.

I.e., focusing on what I COULD do rather that what I COULDN’T.

I came up with a brief, albeit BALLER circuit that made my back feel infinitely better. And, in the months since, whenever someone reached out to me asking for advice (or if a client happened to tweak their back[footnote]Due to unforeseen circumstances, certainly nothing to do with their programming. Let’s not get carried away here…;o)[/footnote]) I’d often revert back to the circuit I laid out for myself and encourage them to follow it as well.

I had been meaning to share the circuit before now, but life has had an uncanny ability of late to get in the way of me doing any writing.

And by that I mean “I’ve been binge watching waaaay too much tv.”

It just so happens, however, that my wife had a bit of a low-back niggle during her training session the other day and I ended up forwarding her my “super secret” workout to tide her over for a few days

She loved it.

In fact, she sent me a text saying something to the effect of…

…”OMG, babe, this back circuit is the best. I am so grateful. In fact, I am so grateful that you never have to empty the dishwasher ever again. And we can watch WWII documentaries whenever you want. Also, let’s make out.”

(just a slight exaggeration there).[footnote]She actually said we can watch Jason Bourne movies whenever I wanted.[/footnote]

Long story, short…below is the workout. There’s a degree of predictability and a host of exercises that won’t surprise anyone.

But who cares?!?

What works, works.

That said, there’s also a few that should be relatively new.

Shut Up Tony and Show Us the Workout For the LOVE OF GOD

Deadbug

This falls into the “no big surprise” category, but it’s a drill that, when perfected, is an outstanding anterior core exercise (as well as one that helps to dissociate hip movement from LUMBAR movement).

Perform 8-10 repetition per side

90/90 Hip Switches w/ End Range IR

This drill works both hip internal and external rotation simultaneously. Be sure to maintain a braced core throughout the set and really focus on moving through the hips and ramping up tension on the IR hold with each repetition.

Perform 4-5 repetitions per side (one rep = 3-5s IR hold)

Side Mermaid

This is a drill I borrowed from my guy Vernon Griffith. I don’t know how else to explain it other than it feels AWESOME once you’re done.

I mean, it sucks while you’re doing (but feels great afterward).

Here I’m focusing on pressing my bottom knee into the ground (not foot) while also keeping my (bottom) hip off the ground. Also, try to keep your top leg straight throughout the set pushing your heel through the wall. This will really get that glute firing on all cylinders.

1 rep = 5-10s hold.

Perform 3-4 repetitions per side

Glute ISO Hold

Another doozy I got from Vernon and does a superb job of isolating the glutes and learning to “own” spinal position and full-body tension.

Make a fist with one hand out to your side and then lift your OPPOSITE foot (also off to the side) off the ground making sure to maintain a braced core and to NOT move through the lower back. Hold for a 5-10s count each rep.

You should feel this in your glutes, abs, soul, eyeballs, everywhere.

Perform 3-4 repetitions per leg.

Barrel Roll

Nothing fancy, but the idea here is to think about locking your ribcage to your pelvis and rotating the entire body side-to-side as one unit. This can be regressed to performing from the knees if performing them from a full plank is too challenging.

Perform 8-10 repetitions per side.

Tall Kneel to Stand

Press your hands together to engage your core and to increase full-body tension. This will help to posteriorly tilt the pelvis encouraging more of a “canister” position where the pelvis is stacked underneath the ribcage.

Focus on maintaining a neutral spine and moving through your HIPS as you transition from the tall kneeling position to standing (and vice versa).

Do not rush this drill; perform it with intent.

Perform 4-5 repetitions per leg.

Birddog Band Press

Regular Birddogs will work wonders here. Just make sure you’re doing them correctly.

But lets up the ante.

The idea here is to lock in a neutral spine and move through your extremities only. There should be very limited motion through the lower back (I like to tell people there’s a glass of water on the lower back and they don’t want it to spill).

Perform 8-10 repetitions per side.

In-Place Chaos March

I like to think of of these as a “side plank that doesn’t make you want to toss your face into a brick wall.” I think we can all agree the side plank is boring, right?

I mean, it’s a fantastic exercise when done correctly and I’d highly encourage most people to start there. However, we’re on some Liam Neeson “I have a particular set of skills, I will find you, and I will kill you” type of shit right here.

via GIPHY

Think about locking your ribcage to your pelvis and keeping your pelvis steady throughout the set; you want to limit any “teeter-tottering.”

Another way to think about it is to pretend as if your hips are on train tracks. They should remain level the entire time.

You also want to keep the “kettlebell quiet.” It shouldn’t be bouncing around while marching in place. Slow and controlled. No rushing!

Perform 8-10 steps/per leg/side

And That’s It

And that’s it.

I typically recommend performing all the exercises above in circuit fashion resting as needed between each one. All told I’d also recommend performing the entire circuit 2-4 times 1-2x per day for several days (or until symptoms subside and you feel you’re able to begin sprinkling in your normal routine again).

We’ve all seen the statistic: 80% of the population will experience low back pain in their lifetime.[footnote]I often wonder how the statistics change once we account for those populations that include more daily movement in their lives and/or adopt habits that help offset postural or movement distortions? I.e., for instance in some cultures many “sit” in a deep squat stance compared to us Westerners who spend $3000 on ergonomic chairs. I wonder how the stats hold up comparatively speaking? I’m NOT saying posture (or a fancy schmancy chair) is directly correlated with one’s likelihood of developing LBP. But I have to assume the dichotomy between East vs. West cultures may come into play and a discrepancy in the stats exists. Like, do 80% of Asians or indigenous populations or Centaurs experience low back pain?

*shrugs*

Wanna know what else I wonder? What is Ryan Gosling doing this very minute?[/footnote]

Back pain is the single leading cause of disability worldwide. Americans spend upwards of $50 billion per year on back pain. Back pain is the nemesis of all ninjas.

The struggle is real folks.

Given how pandemic the issue is and the sheer number of resources there are on the topic, why is LBP still such a nuisance and the Bane of many people’s existence?[footnote]See what I just did there? Low backs? Bane? Batman? Bane broke Batman’s back. Shit, I’m good.[/footnote]

When it comes to low back pain there is no one clear cut answer or way to explain things. As my good friend David Dellanave would say “different shit is different.”

It’s impossible to definitively point the finger at one or two things and say “there, that’s it. THAT’s why everyone’s back feels like a bag of dicks.”

Certainly we can proselytize, but at the end of the day we’re mostly just guessing at what may be causing someone’s low back pain. We’re using an amalgamation of relevant anecdotes, experiences, expertise, and evidence based research to make those educated guesses.

But it’s guessing nonetheless.

[BEFORE WE MOVE ON: Another good friend, physical therapist Zak Gabor, sent me THIS rather thorough paper on management of low back pain. To quote Zak…”Movement is key, but EDUCATION on false beliefs about the body is arguably most important.”]

A week or so ago as I was watching an episode of VICE News on HBO and one of the main stories that night was on opioid addiction and of a former drug representative who, sadly, because of debilitating low back pain, had become addicted to the very pain killers that had made him so successful years prior.

In the story he described a seemingly endless barrage of treatments ranging from massage therapy and acupuncture to ultrasound treatments, physical therapy, and traction.

It was a hefty list and I can’t remember all of it.

In the end he ended up having back surgery, yet unfortunately was still reliant on pain killers to help with his chronic low back pain.

As the story unfolded they panned to the same individual miniature golfing with his family and I ended up taking a screenshot of him bending over to pick up the ball after sinking a shot.

If I could add sound it would be accompanied with a cacophony of painful grunting akin to a rhinoceros passing a kidney stone.

Now, what follows is not an attempt at me diminishing his experiences, and I’m fully cognizant my only source of info regarding his “treatment” was/is the five minute snap shot I was given from the story.

That said, I wonder how much agony and frustration might have been prevented in his lifetime if someone took the time to show him some basic “spinal hygiene” (to steal a phrase from Dr. Stuart McGill and his book Back Mechanic) tactics to clean up his daily movement?

What might have happened (what can happen?) if, instead of acupuncture, he was shown how to hip hinge well or given a healthy dose of Deadbugs, Birddogs, and Breathing Side Planks?

Repetitive (aberrant) flexion, as shown in the still shot I took, certainly isn’t doing his back any favors. And, I have to assume this type of thing is happening dozens (if not hundreds) of times per day, whether he’s picking up a golf ball or getting out of a chair.

It glaringly demonstrates how we often neglect to address the obvious and simple everyday “hammers” in our lives that can (not always <— this is important) lead to back pain.

Nope, not those hammers.[footnote]Armie Hammer playing the Winklevoss twins in the movie The Social Network[/footnote]

I’m talking about the kind of hammers – repetitive movement (repeated spinal flexion, and extension for that matter) – that start off as innocuous nothings (the twist there, the bending over there), yet manifest into something far more nefarious once one’s tissue tolerance is surpassed.[footnote]To be clear: I am not anti-spinal flexion. The spine is meant to flex. I’m anti-spinal flexion when it clearly exacerbates someone’s symptoms. I’m also anti-LOADED spinal flexion like HERE.[/footnote]

As my friend and strength coach, Joy Victoria, notes:

“Habitual daily postures and movement strategies have a greater influence, than intentional exercise.”

Massage, ultrasound, etc, while likely part of the puzzle (and can provide immediate, albeit temporary relief), are just band-aids.

I think exercise, and to be more specific, strength, can play an integral role in the grand scheme of things.

However, as fitness professionals it’s imperative we keep a keener eye. Deadlifts don’t cure everything. Recognizing run-of-the-mill wonky movement and attacking that, as trivial as it may seem, can make all the difference in the world for those who suffer with low back pain.

I Jacked My Low Back, Now What? Workout